PRIME ENDODONTICS NPI 1275445835

NPI Information

  • NPI: 1275445835
  • Provider Name: PRIME ENDODONTICS
  • Classification: Dentist - 1223E0200X
  • Specialization: Endodontics
  • Entity Type: Organization
  • Address: 17047 HARLEM AVE
    TINLEY PARK, IL
    ZIP 60477
  • Phone: (708) 580-0010

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NPI Details

PRIME ENDODONTICS is an endodontics dentist in Tinley Park, IL. The provider is the branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. PRIME ENDODONTICS NPI is 1275445835. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

17047 HARLEM AVE
TINLEY PARK, IL
ZIP 60477-739
Phone: (708) 580-0010

The provider's authorized official is Mahmoud Mona .
The authorized official title is President and has the following contact phone number (904) 738-1049.

The enumeration date for this NPI number is 9/18/2026 and was last updated on 9/18/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223E0200XDentistEndodonticsYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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